EXERCISES: VALUES CLARIFICATION

In spite of our efforts at objectivity, we all hold personal values that can influence how we respond to patients. These exercises are intended to help you clarify your personal values about pregnancy options and abortion training, and to think about those values in the context of professional judgments you may be called upon to make.

EXERCISE 1.1: General Feelings about Pregnancy Options

Purpose: This exercise is designed to illustrate the range of beliefs about the acceptability of pregnancy options and to help you clarify your personal views about your patients choosing abortion, adoption, or parenthood.

In general, how do you feel about your patients choosing abortion, adoption, or parenting in each of these situations? Are you challenged to accept a patient’s decision in the following circumstances?

If the pregnancy threatens their physical health or life

If the pregnancy involves significant fetal abnormality

If the patient is an active substance use disorder or has had previous children removed by Child Protective Services

If having a child would interfere with their career or education goals

I can accept an informed decision to choose abortion in any circumstance.

Were you surprised by any of your reactions? How have your life experiences contributed to these feelings?

EXERCISE 2: Feelings about Providing Abortions

Purpose: This exercise will help you clarify your feeling about abortion provision.

As you embark on this experience, consider how you might disclose this training to others. Do you think there are any parallels between the stigma that patients and providers experience?

Consider the following quotation on the role of “conscience” in abortion provision, and not just the historical focus on the refusal to participate. What are your thoughts on how this view affects stigma?

“[Providers] continue to offer abortion care because deeply held, core ethical beliefs compel them to do so. They see women’s reproductive autonomy as the linchpin of full personhood and self-determination, or they believe that women themselves best understand the life contexts in which childbearing decisions are made, among other reasons” (Harris 2012).

EXERCISE 3: Abortion Access (Optional)

Purpose: The negative public health impact of restrictive abortion laws is well documented. The following exercise is designed to help you think through the consequences of limited access. How might your decision to offer options counseling, referrals, or services influence the accessibility of abortion where you may practice?

What is your reaction to the following account?

It is estimated that for every 99 U.S. patients receiving abortion, 1 presents for care beyond the capabilities of a particular clinic. Many factors delay patients seeking care. Here are two patients’ explanations of what caused a delay in access to care from the ANSIRH Turnaway Study:

“Still trying to get Medicaid and arrangements to stay for the procedure since it was out of town. Still trying to get insurance.” 23-year old Hispanic patient from New Mexico, at 22 weeks

“I didn’t find out until I was 22 weeks and getting the funding. I was determined but there was so much preventing me from getting up there.” 24-year old white patient from Minnesota, at 24 weeks